CVT 2211 - Critical Care Applications

3 hours Lecture, 3 credit(s)

Lower-Division College Credit

Prerequisite(s): CVT 2421C

Course Description:
This course provides a survey of the theory and applications of critical care measures in medical emergencies. These applications include emergency airways to temporary pacemakers. The student is familiarized with the protocols used for Advanced Cardiac Life Support and then take the ACLS certification test. In addition, comprehensive computerized practice exams for the RCIS registry review are administered during the course in the College computer lab.

Academic Dean’s Contact Information

LAKELAND DEAN’S OFFICE: LLC 2255 PHONE: (863) 297-1024
WINTER HAVEN DEAN’S OFFICE: WSC 101 PHONE: (863) 297-1020

Polk State College Mission and Outcomes

Polk State College is a quality-driven educational institution, providing access to affordable associate and baccalaureate degrees, career certificates, and workforce development programs, delivered by diverse, qualified faculty and staff who are committed to student learning and achievement through the consistent practice of collaboration and focus on excellence. In line with this purpose, Polk State College’s AS programs develop competence in career areas. A primary focus of this course is the development of competencies related to the following program learning outcome(s):

Students will be able to:
1. Demonstrate knowledge and skills necessary for employment in cardiac catheterization labs while assisting physicians
     during diagnostic and interventional cardiac and peripheral procedures.
2.   Distinguish normal versus abnormal conditions that affect cardiac and peripheral systems.
4.   Apply the cognitive and psychomotor domains needed to assist the physician by mastering competencies in patient
     care and technical procedural skills.
5.   Demonstrate the knowledge necessary to acquire the Advanced Cardiac Life Support (ACLS) certification and
     Registered Cardiovascular Invasive Specialist (RCIS) credential.
6.   Demonstrate high standards of professional judgment, ethical standards, and critical thinking skills necessary for an
     entry level invasive cardiovascular technologist.

Course Objectives:

The student will be familiar with emergency airway placement and operation of emergency oxygen delivery from nasal cannula, non-rebreather, ambu bag oxygenation to intubation technique.
The student will identify means of temporary pacing in emergency situations.
The student will begin ACLS training by learning the ACLS algorithms.
The student will take ACLS certification course.
The student will complete computer generated RCIS practice exams for credentialing registry.

Course Content:

1.    The student will be able to determine size of artificial patient airway and oxygen delivery:
            -90mm, 85mm, 80mm airway
                        -jaw thrust maneuver
                        -proper ambu bag use
                        -low-flow system
                                    -nasal cannula 1-6L/min
                                    -simple face mask no less6-10L/min
                        -high-flow system
                                    -non-rebreather mask greater than 10L/min
                                    -oxygen tent

2.   Cardiac Assist Device/Intra Aortic Balloon Pump
            -Indications & contraindications
            -Increased coronary perfusion
            -Decreased LV workload
            -Increase cardiac output
            -Decrease afterload
            -augmented mean arterial systemic pressure
            -balloon, transducer, and pump preparation

3.    Emergency Temporary Pacing:
            -External pacing with defibrillator pads
            -Transvenous pacing with temporary pacemaker & external generator
                        -jugular approach
                        -femoral approach

4.    ACLS protocols:
            -ABC’s (Airway, Breathing, Circulation)
            -OMI (Oxygen, Monitors, IV access)
            -ICEM (IV access, CPR, ET/intubation, Monitors)
            -Reversible Causes of Cardiac Arrest
                        -Hypovolemia
                        -Hypoxia
                        -Hypo/Hyperkalemia
                        -Hypoglycemia
                        -Hypothermia
                        -Acidosis/Alkalosis

5.   ACLS Algorithms:
             PULSELESS VT/VF
                        -ABC’s
                        -ICEM
                        -verify VF with defibrillator and initiate therapy
                                    -360j with monophasic
                                    -200j with biphasic
                        -simultaneously finish ICEM
                        -Drug Therapy:
                                    -Epinephrine 1mg q3-5 min OR Vasopressin 40U iv once followed by epinephrine protocol in 3-5min.
                                    -Amiodarone 300mg IV push, repeat once in 3-5min at 150mg IV bolus
                                    -Lidocaine (1.5mg/kg with max 3mg/kg
                                    -Magnesium Sulfate (1-2g over 1-2 min)
                        -consider and treat causes (volume, rhythm, & pump)
            PULSELESS ELECTRICAL ACTIVITY
                        -ABC’s
                        -ICEM
                        -Drug Therapy
                                    -Epinephrine 1mg q 3-5min OR Vasopressin 40 U IV once followed by epi in 3-5min
                                    -Atropine if brady 1mg q 3-5min with max of 3mg
                        -consider and treat causes (volume, rhythm, pump)
            ASYSTOLE
                        -ABC’s
                        -ICEM
                        -Drug Therapy
                                    -Epinephrine 1mg q 3-5min OR Vasopressin 40U IV once followed by epi in 3-5min
                                    -Atropine 1mg q 3-5min with max on 3mg
            BRADYCARDIA (rate <60 bpm)
                        -ABC’s
                        -OMI
                        -determine stable vs. unstable
            -If adequate perfusion; observe and monitor
            -If inadequate perfusion
                        -transcutaneous Pacing
                        -consider Atropine .5mg to max 3mg while waiting for pacer
                        -consider Epinephrine 2-10mcg/min drip
                                     Dopamine 5-20 mcg/kg/min drip
                        -consider and treat causes
            NARROW QRS COMPLEX TACHYCARDIA (stable)
                        -ABC’s
                        -OMI
                        -Vagal maneuver
                        -Adenosine 6mg, 12mg, 12mg 1-2min apart
                        -if no conversion consider Ca Channel Blocker (Diltizaem) or B- Blocker
            NARROW QRS COMPLEX TACHYCARDIA (unstable)
                        -ABC’s
                        -OMI
                        -sedate patient and attempt cardioversion
                                    -A-Fib initial dose 100-200j
                                    -A-Flutter & SVT initial dose 50-100j
            WIDE QRS COMPLEX TACHYCARDIA (stable)
                        Monomorphic Ventricular Tachycardia
                                    -Drug Therapy
                                                -Amiodarone 150mg IV over 10min
                                    -consider cardioversion
                        Supra Ventricular Tachycardia
                                    -Drug Therapy
                                                -Adenosine 6mg, 12mg,12mg 1-2min apart
                        A-Fib with aberrancy
                                    -Drug Therapy
                                                -Cardizem
                                                -B-Blockers
                        A-Fib with WPW (Wolfe-Parkinson-White Delta Wave)
                                    -Drug Therapy
                                                -Amiodarone 150mg IV over 10min
                                                -AVOID Adenosine, Digoxin, Cardizem, Verapamil
                        Toursades de Pointes
                                    -Drug Therapy
                                                -Magnesium 1-2g over 1-2min
            WIDE QRS COMPLEX TACHYCARDIA (unstable)
                      Monomorphic Ventricular Tachycardia
                                    -sedate and cardiovert initially dose 100j; then step 200j; 300j;360j monophasic defibrilator
                        Polymorphic Ventricular Tachycardia
                                    -sedate and defibrillate 360j monophasic and 120-200j biphasic
            ACUTE MYOCARDIAL INFARCTION
            ACUTE STROKE
1.            ACLS Certification Test.
2.            Self paced registry review tests at airside computer lab.

Textbook and Other Requirements

Textbook information is provided in the course syllabus, at the campus bookstore, and on the campus bookstore website at: www.efollett.com.

The Gordon Rule

This is not a Gordon Rule course.

Student Help

The professor is available for help during posted hours and by appointment during other non-class hours. Students are encouraged to seek assistance from the professor. To further the educational process, the campus Learning Resources Centers, comprised of the Teaching/Learning and Computing Center (TLCC) and library, are available for student use. Each resource provides qualified staff and up-to-date equipment and facilities to promote students’ academic success. The TLCC provides tutoring services, computing resources, and other instructional support. The library provides information resources, individual and group study space, research assistance, information literacy instruction, and computing resources. Each facility provides free wireless access to the Internet. Polk State College Library and TLCC hours of operation and tutoring schedules are posted at each facility and on the Polk State College website.

Withdrawing From a Course

Students may officially withdraw from course(s) during any given term, provided they follow the appropriate policy and procedure. Following the conclusion of the Drop/Add Period, a student may officially withdraw without academic penalty from any credit course, provided he or she has submitted the appropriate forms to the Student Services Office no later than the published deadline. The published deadline reflects approximately (but no more than) 70% of the term, based upon the course’s scheduled duration. It is the student’s responsibility to submit these withdrawal forms; failure to do so may result in a grade of F in the course. Under the Forgiveness Policy, a student is allowed only three attempts in any one course: one initial enrollment and two repeats. A student is not allowed to withdraw from a third course attempt. Limited admission programs may have specific guidelines regarding withdrawing from courses that vary from this policy. Please see the student handbook for that program for more information. If a student stops attending class, the grade earned, usually an F, is assigned and posted. Prior to withdrawing from a course, the student should consult with the Financial Aid Office to determine what impact, if any, withdrawal from the course will have on his or her financial aid status. A student cannot use course withdrawal to avoid academic dishonesty penalties. A student who has been penalized for academic dishonesty in a course is not eligible to withdraw from the course.

A student who withdrawals or fails any CVT course during their first semester of the first year may return the following year on a “clinic space availability” basis with permission from the Program director (remedial activities may be given at this time). A student who withdrawals or fails the same CVT course two times will be dismissed from the program. The student may reapply through the readmit application process within one year and is subject to the “clinic space available” basis with permission from the Program director. A student must successfully demonstrate the appropriate level clinical skills to the Clinical Coordinator prior to returning to the clinical setting after an absence of one semester or more.

Repeating a Course

Under the Forgiveness Policy, a student is allowed only three attempts in any one college credit course: one initial enrollment and two repeats. Under certain circumstances, a student may petition to repeat a credit course beyond the three attempts. Limited admission programs may have specific guidelines regarding repeating courses that vary from this policy. Please see the student handbook for that program for more information. The student should be aware that repeating a course may result in a higher course cost. A course cannot be repeated unless the previously earned grade is a D, F, or W (the Polk State College Catalog provides further details regarding this process). Prior to repeating a course, the student should consult with the Financial Aid Office to determine what impact, if any, repeating the course will have on his or her financial aid status.

Academic Dishonesty

Each student is responsible for his or her work. It is assumed that each student is honest and will abide by this standard; however, in the event that there is an indication or suspicion of cheating/plagiarism, the situation shall be dealt with in accordance with the published College policy. Copies of this policy are available in the Student Services Office. Students should also refer to the course syllabus for more specific information.

Information Technology Access/Use Policy

All individuals who employ the information technology resources provided by Polk State College (this includes, but is not limited to, telephones, computers, the Polk State College Local Area and Wide Area Networks, and the Internet) must use these resources for academic purposes only. Use of these resources is a privilege, not a right. Inappropriate use can result in revocation or suspension of this privilege.

Equal Access/Opportunity

Polk State College is an equal access, equal opportunity institution committed to excellence through diversity in education. The College complies with all state and federal laws granting rights to applicants for admission to the College. Polk State College is committed to the equitable treatment of all students in a learning environment free of discrimination and harassment. Polk State College’s Equity Officer ensures compliance with federal and state laws prohibiting discrimination and sexual harassment. Students who believe they have been a victim of discrimination or sexual harassment should contact the Polk State College Equity Officer, Ms. Valparisa Baker, at 863-292-3602 or vbaker@polk.edu.

Equal Opportunity For Students With Disabilities

The College complies with the Americans with Disabilities Act and provides equal educational opportunity for qualified individuals. A student with a disability who requires special accommodations or auxiliary aids under The Americans with Disabilities Act (ADA) should contact the Student Services Office on either campus and speak with the Coordinator of Academic Advising.

Evaluative Criteria:
Multiple choice tests, quizzes, equipment/procedure check-off, individual assignments and projects, group activities, hands-on scenarios, computer based review, and/or professional behavior.

Grading Scale:
92 – 100          A
84 – 91            B
75 – 83            C
70 – 74            D
69 or lower      F

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